Janet Opie, Research Fellow (Correspondence); Richard Rosewarne, Senior Research Fellow; Daniel W. O’Connor, Professor of Psychogeriatrics
The efficacy of psychosocial approaches to behaviour disorders in dementia: a systematic literature review
Article first published online: 24 DEC 2001
Australian and New Zealand Journal of Psychiatry
Volume 33, Issue 6, pages 789–799, December 1999
How to Cite
Opie, J., Rosewarne, R. and O’Connor, D. W. (1999), The efficacy of psychosocial approaches to behaviour disorders in dementia: a systematic literature review. Australian and New Zealand Journal of Psychiatry, 33: 789–799. doi: 10.1046/j.1440-1614.1999.00652.x
Aged Mental Health Research Group, Kingston Centre, Warrigal Road, Cheltenham, Victoria 3192, Australia. Email: Janet.Opie@med.monash.edu.au
Daniel W. O’Connor, Professor of Psychogeriatrics
Department of Psychological Medicine, Monash University, Melbourne, Australia
- Issue published online: 24 DEC 2001
- Article first published online: 24 DEC 2001
Objective: This paper provides a systematic review of research findings published between 1989 and 1998 concerning non-pharmacological strategies to alleviate behavioural disturbances in elderly persons with dementia.
Method: Data collection strategies included computer literature searches, manual searches of selected journals and checks of references listed in previous reviews. To warrant inclusion, studies were required to include some measure of behaviour before and after the introduction of an intervention. Papers were appraised in the following domains: design, sampling technique, setting, behaviours studied, measurement tools, data collection methods, type of interventions and feasibility. An overall validity rating was assigned to each article using predetermined rules.
Results: Forty-three studies met criteria for inclusion including five randomised controlled trials. Validity ratings were as follows: one strong, 15 moderate, and 27 weak. Areas of scientific weakness included small numbers of subjects, inadequate descriptions of study participants, imprecise data collection methods, high attrition rates and insufficient statistical analysis. Despite this, there is evidence to support the efficacy of activity programs, music, behaviour therapy, light therapy, carer education and changes to the physical environment. The evidence in favour of multidisciplinary teams, massage and aromatherapy is inconclusive.
Conclusions: It was easier to interpret the results of rigorously designed studies that focused on a single behaviour or single intervention tailored to the needs of individuals and carers. Future studies should seek to replicate the findings outlined here, improving methodologies where necessary and including outcome measures that encompass the interests of people with dementia, family caregivers and health professionals.